I recently attended a professional conference where this topic was one of the break-out sessions that I attended. The following is a synopsis of the presentation.

Proficiency in writing is an expectation for graduates of the Associate Degree Nursing Program. To assist the students with improving their professional writing, they have the option of working with the Writing Lab on campus. I have arranged an APA session for students given by the Gen Ed instructor or the Librarian on this Campus to improve their assignment quality and thoroughness for my 2nd semester students. I especially recommend the writing lab to the students when they are working on a paper in APA format. Others things that you can do, as a faculty member, are to communicate the purpose of the assignment to the students, utilize a grading rubric for all assignments especially the major ones, and always give the students feedback. Students learn from timely feedback. Professional writing is so important as the expectation is that a nurse needs to write professionally for her/his career. Some examples of the need for professional writing are; developing a proposal, revising or creating a new policy,communicating with superiors, or working on a budget. Another activity that may benefit a student is peer mentoring. Prior to turning in a project the student has another student review the project and grade according to the rubric, whether it is a scholarly paper or the weekly clinical care plan. The student should also be using the rubric to self-assess their project prior to submitting to the instructor.

Submission of assignments could be electronic . Can you create a mechanism to de-identify papers and grade in random order?

Writing supports reflection which strengthens connections between thinking and learningand promotes creativity, which is the highest order in the new Bloom’s taxonomy. Evidence-based practice is an important aspect in all assignments the nursing student may have to do. This presenter suggested that you/your Division create an APA checklist format to grade papers, including the APA page number on the checklist. The student will then submit their paper checking that they have completed all the elements of the project and the instructor compares the self-assessment with their assessment. This checklist should be consistent with all faculty. I’m not sure if we currently have something like this College-wide but it might be a good suggestions.

I was recently evaluating the literature related to Evidence-Based practice in nursing and came upon a research article entitled ‘Never Change Answers on Examinations: Evidence-Based Practice In Nursing Education’, in the Journal of Nursing Education. This article pretty much dispelled what I have been telling students most of my teaching career; do not change your original answer on an exam because most of the time it will be to your detriment. The article discusses that “going with your gut” strategy for testing is not evidence-based. The majority of studies, past and present, suggest that when students change answers on their tests, they generally end up with a higher score than if they had not changed any answers. When I review an exam, I can tell by the scantron test form if a student has changed an answer on a question. I usually only monitor when they have changed a correct answer to an incorrect answer, and ignore the number of times that they may have changed an incorrect answer to a correct answer. This article recommends that students need to be informed that changing answers on a test can be beneficial and give them a higher score on the exam. When students review their exam they may feel regret for having changed their answer to a wrong answer. This article suggests that the students also look to see if they changed an incorrect answer to a correct answer, to minimize the feeling of regret for the wrong choices. It was noted that students do not have the opportunity to change their choice on their licensure exam, NCLEX-RN or NCLEX-PN, and maybe that should be evaluated for future testing, allowing for changing of initial answers.

“The bottom line is that faculty should not discourage students from changing answers. If anything, faculty should explain to students that changing answers, when there is some rationale for the change, may indeed be helpful.”

It has been noted by nursing faculty that students returning to school for their 2nd semester clinical often are not able to competently perform the Basic Nursing skills that they learned the previous semester. In this case, the students had the summer off. The clinical rotation will be in the acute care setting and requires that the students come prepared with confidence and competence with those nursing skills. The idea of a Nursing Clinical Boot Camp was created. With another faculty member, we created the following activities:

Have students arrive for the Boot Camp in appropriate clinical uniform and appearance.

One instructor collaborated with the students to review a Case scenario with care plan development, low tech, paper and pencil. The feedback from the students was that they wanted more.

One instructor created a scenario utilizing the simulation mannikin:

1. Hospital Room or Horrors – the situation is created to simmulate potential safety issues in the patient room in a hospital and the students have to assess the patient and identify areas of concern, working collaboratively and correcting the deficiencies.

2. Simulation- mannikin with make-up and wig. Case scenario developed including patient history, medications, laboratory values. An order set from the provider. Student had to do the following basic skills: oxygen delivery devices, incentive spirometry, respiratory inhaler with use of a spacer device, IV therapy utilizing an infusion pump, insertion of a foley catheter, vital signs, assessment of heart/lungs. The scenario included abnormal findings which directly related to the patient history and the current condition.

3. One student was the charge nurse and delegated to the other team members to facilitate completion of the provider orders.

4. Instruction related to Low Molecular Weight Heparin Injection, needle gauges, use of a Carpuject, use of a cryo-cuff.

5. The Nursing Academic Coach also spoke with the students about her role, how to access her Blackboard site, as well as other tutoring sessions with a student tutor.

One suggestion was to include Nasogastric Tube care in future sessions. That can easily be accomplished on the first day of their clinical orientation.

The students showed enthusiasm and were very appreciative of the sessions presented. Both instructors felt the time was used wisely and effectively.